What I've Learned: Injury Edition

As much as it sucks to have to go through a running-related injury, it really is a good opportunity to learn a few things and my most recent injury was no exception. About 6 weeks ago I posted about the ins and outs of IT Band Syndrome and in the intervening time, I've learned several other things about that injury (in particular) and about preventing injury in general. 

#1) Strength Training is Vital.
I'm not suggesting anyone go out and start doing 'Cross-Fit' tomorrow, that would probably be counter-productive. The goal of strengthening work for a runner is not bigger muscles. The goal is stronger muscles  and muscle maintenance. The reason that strength training is so important is because the act of running itself makes certain muscle groups weaker. In particular, runners typically have weak hip muscles (hip abductors and adductors) because most of our running is done in a relatively straight-line and so the outside hip muscles never really get much work. If you think of the space between your hip and the bottom of your foot as a system, all the parts have to kept in good working condition in order for the system to work most efficiently. Any imbalance is going to cause other muscles to have to work harder and that compensation is what leads to injury. 

#2) If you feel pain, take a day or two off. Listen to your body.
As I've progressed in my experience as a runner, I've become better at this, but this IT Band Syndrome was a good example of me not listening to my body. I ran for at least three days from when I first started feeling pain in my knee instead of taking a day or two off right away to let it die down. Because I ran on it, I quickly progressed from a mild case of ITBS to a severe case and that meant 6 weeks on the DL. 

#3) Shoes are important.
I'm not about to re-join the Great Shoe Debate, but my thoughts have changed with regards to footwear. I still don't think that shoes can prevent injury. By that I mean, if you have bad form (heel-striker, over-pronator, etc) shoes will not fix the problem. However I now believe that if you good form, a shoe can injure you. I wish that I had gone to a shoe store that had the technology to take a good look at my gait. Most running specialty stores have this nowadays and if I had done that, I likely would not have ended up getting an arch-support shoe and would have instead opted for a neutral shoe, thus preventing this whole thing. Go get your gait checked if you haven't already. Most of these stores offer it for free and it's easy to do. 

#4) Have a mind-set that is long-term.
As I got closer and closer to the date of the New York Half, I seriously questioned whether it was a good idea for me to attempt to run the race. The simple fact was that I hadn't been able to train properly for it and risked re-aggravating everything by attempting to do it. In the back of my mind I knew that the real goal was to run the Chicago Marathon next fall and that compromising that to simply participate in a half marathon seemed foolish. If it hadn't been for a couple of 100% pain free training runs during the week leading up to the half, I likely would not have run it. I could have tried but it wouldn't have been worth it to me. As much as it would have sucked to sit out, my goal is a) to run pain free and b) to complete a marathon. 

#5) Find people you can talk to about it (other runners).
For me this was a life-saver. Between my wife, my buddy Stephen and my brother (among others) - I had people to talk to about the injury, to ask me how I was doing, to share the disappointment with and to ultimately share the triumph with when I was able to complete the race. I'll never forget when I had that first pain-free training run...I raced home and then immediately started calling people who'd stuck with me through the whole thing. It was really great to have support around to deal with the disappointment and setbacks. 

#6) Keep doing research.
From the time that the pain started to when it finally went away, I was scouring the internet for answers. I was telling Stephen that I now know more about ITBS than I ever cared to know. I've talked to people about it, I've had runners I know talk to other runners they know about it, I've spent hours combing websites for information and I've learned a lot. For example, you cannot stretch the IT Band. It is connected to the muscles of your hip (tensor fasciae latae) and to the top of the tibia. You can't stretch your IT Band any more than you can bend your femur. You can stretch the muscles around it, but that's as good as you're going to get. Also, despite the fact that ITBS sufferers often feel the pain in their knee, the real problem isn't in the knee, it's usually above or below in the hip or feet. 

#7) Keep your head up.
By accident I stumbled upon a blog entry a few months ago (before all this started) that said something along the lines of, "no matter what running injury you have, eventually it will go away." I wish I could link you to the blog post, but I can't seem to find it. Anyway - it's easy to get really down and the longer an injury wears on, the more it seems like maybe you'll never run again. Try to be positive and try to find other things that you can do. For me it was pool running, biking, lifting, swimming, etc.

I'm sure what I've had to say is nothing new under the sun. Being injured sucks but it's also a good opportunity to learn and if you're a blogger it's a good chance to learn and share that knowledge with other people. I was surprised to come across a couple of people that were also suffering with ITBS and it was really cool to be able to share things with them regarding what was and wasn't working.

IT Band-ter

Sorry for the title - I'm trying too hard to be clever. This post is about the IT Band and, more to the point, IT Band Syndrome which is my latest injury. My training for the New York Half Marathon had been going great up until last Tuesday when I started to notice some very slight pain on the outside of my left knee. I didn't think much of it -- I'm pretty clumsy sometimes and end up hitting my knee on things like the living room table, so I figured it might just be a bruise from such an incident. On Wednesday the pain got worse, but it still didn't rise to a level where I was all that concerned about it. On Thursday I had a speed workout planned and the farther I ran, the more it hurt...but then at a certain point the pain disappeared and I thought, "hey, maybe it's gone." Then I got off the treadmill...and I could barely walk - it was a very sharp pain that hurt even when I was gingerly walking along. It killed to walk down steps, it killed whenever I would get up out of a chair, it was tender to the touch. It was then that I thought I should probably do some investigation so I went to the trusty interwebs and learned more than I cared to know about IT Band Syndrome.

If you've been a runner for any longer period of time, IT Band Syndrome is not a new term in your vocabulary. It is one of the most common running injuries and is caused by a wide variety of factors. The IT Band (iliotibial band) is actually a very long tendon that runs from your hip to your knee and IT Band Syndrome is essentially a "tendonitis" of sorts -- an inflammation of that tendon. It can be caused by an IT Band that is too wide or too narrow (genetic), it can be caused by overuse (most common) and it can be caused by faulty running mechanics (excessive over-pronation, etc). The most common cause, as I said, is overuse and by that I mean an increase in miles or intensity of training that is done too quickly. In my case I thought I was being somewhat conservative in my training, but as I look back at it - along with a marked increase in miles was an ambitious increase in intensity which I think it what did me in.

The number one treatment for IT Band Syndrome is a runner's least favorite word -- and that's rest. I hate that word. Rest is a euphemism for "don't run" and I feel like with every passing day that I don't run, I'm losing valuable training time. I have just over 6 weeks until the New York Half and I really want to be in tip-top shape. That being said, it is nearly impossible to run with this pain and I would really like to be rid of it before I continue with my training schedule. Fortunately for me, there are a number of things I can do to help speed my recovery.

#1) Ice. A runner's best friend. Almost every article I've read on IT Band issues suggests making icing a priority. 15-20 minutes, 3 times a day (at least).


#2) Use a foam-roller. I didn't have one prior to Friday, but my wife and I bought one and I've been using it ever since. There's a good video on how to use it specifically for the IT Band here on YouTube.

#3) Stretch it out. There are a couple of good stretches in that video as well, but if you do a quick Google search on IT Band stretches, there are many and stretching is key to loosening up your IT Band. IT Band Syndrome is a result of that Band being extremely tight.

#4) Strength Training. As I've read, it's probably not a good idea to start strength training if you're still having pain - but once the pain goes away, the key to preventing future IT Band issues is to strengthen a few key muscle groups. Many of us runners, myself included, can be tempted to completely neglect strength training. This can lead to a whole host of issues and one of them is IT Band Syndrome. Runners tend to be weak in predictable areas and one of those areas is the hips. For more information on specific strength training that can be done to prevent IT Band issues, read this article.

My pain has slowly decreased over the past few days to the point where I may try a get short run tomorrow. I've been icing when I can, foam-rolling a few times a day and stretching. I also was looking around online and found this handy little tool, called the Patt Strap, that I'm hoping will also help. I just bought it today so I'll let you know if it works (or even helps). I'm hopeful that this injury won't sideline me for long, though I am prepared to take the necessary time off in the event that the self-therapy I've been using proves ineffective. I know that this is the type of injury that can linger for a long time if not addressed and in my mind, that would be the worst-case scenario. I would love to hear from any of you out there who've also had experience with this injury to know what helped (or didn't help) you overcome it. Cheers.